{
"Npi": {
"NPI": "1831499557",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "QUADREN LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8001 N DALE MABRY HWY",
"SecondLineMailingAddress": "BUILDING 801 SUITE #A",
"MailingAddressCityName": "TAMPA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33614-3290",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-935-4936",
"MailingAddressFaxNumber": "813-935-4938",
"FirstLinePracticeLocationAddress": "8001 N DALE MABRY HWY",
"SecondLinePracticeLocationAddress": "BUILDING 801 SUITE #A",
"PracticeLocationAddressCityName": "TAMPA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33614-3290",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-935-4936",
"PracticeLocationAddressFaxNumber": "813-935-4938",
"EnumerationDate": "10/28/2010",
"LastUpdateDate": "02/22/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YUSUF",
"AuthorizedOfficialFirstName": "TAJUDEEN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "813-480-9223",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH24258",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}